Identifying Optimal Antibiotic Regimens to Treat Urinary Tract Infections During Pregnancy

项目摘要 尿路感染（UTI）在妊娠期很常见，可造成严重后果，包括 流产和早产。少数民族和种族群体可能有较高的UTI率， 怀孕，但以前的研究有很大的局限性。虽然有证据表明，有种族和 种族差异的诊断和治疗其他感染，鲜为人知的是，潜在的差异，尿路感染 怀孕期间的治疗。这种多样性补充将支持桑德拉麦卡蒂尔女士，一个有才华的硕士 华盛顿大学流行病学专业的学生，进行相关研究并获得技能， 作为项目经理，成功的职业生涯所需的经验，领导干预措施，以改善健康 妇女和儿童。麦卡蒂尔女士的主要导师将是凯撒医疗机构的萨沙都柏林博士 华盛顿，合作研究员的父R 01赠款。华盛顿大学的Anjum Hajat博士将 共同导师，带来健康差距研究方面的专业知识。父R 01旨在生成所需的 通过分析有关妊娠期使用抗生素的安全性和有效性的证据， 行政索赔和电子健康记录数据。母公司R 01的具体目标是：1） 描述真实世界的处方模式，与现有指南的一致性，以及抗菌 与妊娠期UTI门诊治疗相关的易感性模式; 2）比较 常用抗生素治疗方案的治疗失败; 2）评价这些治疗方案的相对安全性 关于出生缺陷和围产期并发症的抗生素方案。父R 01不包括 一个健康公平的焦点，特别是，它不检查是否有差异，在UTI发病率或 治疗或按人种或种族划分的抗菌素耐药性的患病率。建议的具体目标 多样性补充研究是为了表征不同的发病率和治疗的尿路感染， 按患者种族和民族列出的妊娠，包括抗生素选择的差异和 临床指南治疗。为了探索性的目的，McAteer女士将研究抗菌药物 种族和民族的抵抗。McAteer女士的职业发展和研究计划将包括 课程作业，指导阅读，参加研讨会和会议，并进行研究支持 由一群多学科的导师组成。这些活动将帮助她建立科学和专业技能 作为一名项目经理的成功职业生涯，领导改善妇女健康的干预措施， 代表性不足群体的儿童。影响：拟议的多样性补充将增加母公司 R 01通过增加对健康公平的关注，并增加对发病率和治疗差异的了解， 按种族和民族划分的UTI。研究结果可用于制定有针对性的干预措施，以改善泌尿系感染的护理， 怀孕，并最终改善孕妇和婴儿的健康结果。

PROJECT SUMMARY Urinary tract infections (UTIs) are common in pregnancy and can have serious consequences including pregnancy loss and preterm birth. Minoritized racial and ethnic groups may have higher rates of UTI in pregnancy, but prior studies had important limitations. While some evidence suggests there are racial and ethnic disparities in diagnosis and treatment of other infections, little is known about potential disparities in UTI treatment in pregnancy. This Diversity Supplement would support Ms. Sandra McAteer, a talented master's student in Epidemiology at the University of Washington, to conduct relevant research and gain skills and experience needed for a successful career as a program manager leading interventions to improve the health of women and children. Ms. McAteer's primary mentor will be Dr. Sascha Dublin of Kaiser Permanente Washington, Co-Investigator on the Parent R01 grant. Dr. Anjum Hajat of the University of Washington will be co-mentor, bringing expertise in health disparities research. The Parent R01 aims to generate needed evidence about the comparative safety and effectiveness of antibiotics in pregnancy by analyzing administrative claims and electronic health records data. The Specific Aims of the Parent R01 are: 1) to characterize real-world prescribing patterns, concordance with existing guidelines, and antimicrobial susceptibility patterns relevant to the outpatient treatment of UTIs in pregnancy; 2) to compare the risk of treatment failure with commonly-used antibiotic regimens; and 2) to evaluate the comparative safety of these antibiotic regimens with respect to birth defects and perinatal complications. The Parent R01 does not include a health equity focus, and specifically, it does not examine whether there are differences in UTI incidence or treatment or in the prevalence of antimicrobial resistance by race or ethnicity. Specific Aims of the proposed Diversity Supplement Research are to characterize differences in the incidence and treatment of UTI in pregnancy by patient race and ethnicity, including differences in choice of antibiotic and concordance of treatment with clinical guidelines. For an exploratory aim, Ms. McAteer will examine differences in antimicrobial resistance by race and ethnicity. Ms. McAteer's Career Development and Research Plan will include coursework, directed readings, participation in seminars and conferences, and conducting research supported by a multidisciplinary group of mentors. These activities will help her build the scientific and professional skills for a successful career as a program manager leading interventions to improve the health of women and children from underrepresented groups. Impact: The proposed Diversity Supplement will augment the Parent R01 by adding a health equity focus and increasing knowledge about differences in incidence and treatment of UTIs by race and ethnicity. Results could be used to develop targeted interventions to improve care for UTIs in pregnancy and ultimately to improve health outcomes for pregnant people and infants.